Conceptual implicit memory performance in Alzheimer's disease.

Alzheimer's disease (AD) patients often exhibit deficits on conceptual implicit memory tests such as category exemplar generation and word association. However, these tests rely on word production abilities, which are known to be disrupted by AD. The current study assessed conceptual implicit memory performance in AD patients and elderly control participants using a conceptual priming task that did not require word production (i.e., semantic decision). Memory performance was also examined using a category exemplar generation test (i.e., a conceptual priming task that required word production) and a recognition memory test. AD patients exhibited deficits on the semantic decision task, the category exemplar generation task, and the recognition memory task. The results indicate that the conceptual memory deficits observed in AD patients cannot be attributed completely to word production difficulties.

Naturally occurring and experimentally induced tip-of-the-tongue experiences in three adult age groups.

Tip-of-the-tongue (TOT) experiences were examined in 30 young (ages 18-24 years), 30 young-old (ages 60-74), and 30 old-old (ages 80-92) adults. In Study 1, TOT experiences were experimentally induced with definitions of to-be-retrieved targets. If the target was not retrieved, orthographic or semantic cues were provided. Age-related increases in the occurrence of TOT experiences and in the time needed to resolve TOT experiences were found for young versus young-old and young-old versus old-old groups; all comparisons were significant except for young versus young-old TOT occurrence, which approached significance. In Study 2, the same participants recorded naturally occurring TOT experiences in structured diaries during a 4-week interval. Both the number of TOT experiences and the resolution time for TOT experiences increased with age. However, the percentage of TOT experiences resolved was equal across age groups; given enough time, even the oldest participants resolved virtually all TOT experiences.

Independent frontal-system deficits in schizophrenia: cognitive, clinical, and adaptive implications.

This study examined whether frontal-system impairments in schizophrenia occur independently of one another and whether they have distinct implications for information processing, symptom severity, and adaptive functioning. We assessed 26 medication-free schizophrenic outpatients and 18 normal control subjects on eight frontally mediated tasks, semantic information processing, IQ, the BPRS, and long-term psychosocial adaptation. Schizophrenic subjects showed three types of deficits, which were uncorrelated with one another: (1) Executive dysfunction (inflexible problem solving) was related to decreased use of expectancy during controlled semantic priming, lower intelligence, more severe negative symptoms and stereotyped mannerisms. (2) Disinhibition of responses (to irrelevant stimuli) was associated with increased automatic priming, a trend for more severe hallucinations, and was unrelated to intelligence. (3) Motor dyscoordination (inaccurate, dysfluent motor sequencing) was not related to semantic processing, intelligence, or symptoms. Furthermore, all three impairments were unrelated to generalized slowness, age, sex, illness length, or pre-washout neuroleptic dose. Two deficits accounted for aspects of long-term psychosocial adaptation, even after statistical correction for IQ: Executive dysfunction was associated with younger illness onset, poor purposefulness and planning, impaired social relations, and lower global functioning. Motor dyscoordination was associated with poor treatment outcome and restricted educational advancement. Furthermore, executive and motor deficits interacted significantly; subjects who had both deficits showed the least favorable treatment outcome. These findings are neither consistent with generalized impairment nor with a unitary 'frontal syndrome' in schizophrenia. They provide preliminary evidence for at least three frontal-system deficits (dorsolateral, orbital, and premotor), which are dissociable from one another, can occur without general intellectual impairment, and have distinct implications for long-term adaptive functioning.

Well-organized conceptual domains in Alzheimer's disease.

We used a novel apparatus called the flags board to elicit similarity judgments from 32 Alzheimer's disease (AD) patients and 32 elderly normal (EN) controls for two 12-member conceptual domains, ANIMALS and (musical) INSTRUMENTS. Based on Pathfinder and multidimensional scaling (MDS) analyses, performance by AD patients was nearly identical to that of EN controls for ANIMALS. Performance differed for INSTRUMENTS, but the AD group's Pathfinder network was found to agree with the intuitions of a panel of 18 raters as well as the EN group's. MDS analysis showed no deficit on abstract dimensions for the AD group, for either domain. The results are discussed in the context of degradation versus preservation of semantic memory in AD.

Predictors of perceived memory impairment: do they differ in Alzheimer's disease versus normal aging?

Predictors of perceived memory impairment were investigated in 40 elderly normal adults and 28 individuals with Alzheimer's disease. Measures of perceived memory impairment, global cognitive functioning, memory, use of memory strategies, memory strategy efficacy, and depressive symptomatology were obtained for all participants. The elderly normal and Alzheimer's disease groups did not differ in the extent to which they reported perceived memory impairment. For both participant groups, more frequent use of memory strategies and lower perceived memory strategy efficacy were significant predictors of perceived memory impairment. Depressive symptomatology was an additional, significant determinant of perceived memory impairment for the elderly normal group.

Slower and more variable reaction times in schizophrenia: what do they signify?

Extensive research has demonstrated that schizophrenic subjects are slower than normal comparison subjects on a range of reaction-time tasks. Some investigators have also observed that schizophrenic patients exhibit larger intraindividual variability in reaction times when performing these tasks than do normal comparison subjects. This study, using a lexical decision choice reaction time (CRT) task, explored the relation of mean CRT and it intra-individual variability (CRT-SD) to psychiatric symptoms and to performance on executive-motor tasks in 26 medication-free schizophrenic out-patients and 17 normal comparison subjects. Schizophrenic subjects had both significantly slower and more variable CRTs which were unrelated to general intellectual abilities (IQ). Among schizophrenic subjects, both CRT and CRT-SD were significantly related to severity of psychotic symptoms, failure to maintain cognitive set, and poorer motor coordination and global functioning. After controlling for mean CRT, CRT-SD showed unique covariation with clinical symptoms (positive, disorganized and tension/hostility). Conversely, mean CRT showed unique covariation with the failure to maintain cognitive set and with stereotypic mannerisms, independent of CRT-SD. These results suggest that slower CRT and increased intra-individual variability in CRT, while not fully independent of one another, may reflect separate aspects of symptomatic and cognitive dysfunction in schizophrenia.

Automatic versus controlled semantic priming in schizophrenia.

Schizophrenic individuals (n = 31), including paranoid and nonparanoid diagnostic subgroups, and normal controls (n = 20) participated in a semantic priming experiment involving a single-choice lexical decision task. For the automatic priming blocks, a 260-ms stimulus onset asynchrony (SOA) was used; for the controlled priming blocks, 1,000-ms SOA was used. The paranoid subgroup showed significantly less priming than did the control group. The nonparanoid subgroup showed a decrease in priming compared with the control group that approached significance. There was an increased priming effect for the controlled compared with the automatic priming condition; this difference was not modulated by participant group. Nonsignificant semantic priming (equal to 0) occurred only for schizophrenic subgroups and only in automatic priming conditions.

Clinical and neurocognitive aspects of source monitoring errors in schizophrenia.

OBJECTIVE: Source monitoring, an aspect of memory that involves judgments about the origin of information, has been found to be more prone to errors in schizophrenic subjects than in normal persons. To examine the precise nature of such errors and their relationship to clinical and neurocognitive variables, the authors compared schizophrenic and normal subjects. METHOD: Schizophrenic subjects who had been medication free for 1 week (N = 26) and demographically matched normal subjects (N = 21) performed a source monitoring task and were assessed on current psychiatric symptoms, IQ, and frontal lobe functioning. RESULTS: The schizophrenic subjects had normal recognition memory of target words (recognition hits) and a normal generation effect but made more errors than the comparison subjects in identifying the source of target words. Specifically, the schizophrenic subjects made more errors in remembering the source of new and self-generated items, and they tended to attribute items to an external source. In 11 retested subjects, these errors were stable and independent from medication status after a 2-year interval. Secondary analyses suggested that certain source monitoring errors may be associated with hostility and lower IQ. When the effect of IQ was controlled, correlations with frontal dysfunction were not significant. CONCLUSIONS: Schizophrenic subjects make significantly more source monitoring errors than normal subjects, but not because of problems with recognition memory hits or with the generation effect. This tendency may be trait like and may be related to hostility. Lower IQ in schizophrenia plays a partial role in these errors, but frontal dysfunction does not.

Methodological control of semantic priming in Alzheimer's disease.

We conducted a lexical-decision, semantic priming experiment that included 250- and 1000-ms stimulus onset asynchronies (SOAs) with 32 probable Alzheimer's disease (AD) and 40 older normal persons. Attention-based, controlled processes are assumed to occur only at the longer of the 2 SOAs. The AD group showed greater than normal priming in the long-SOA but not the short-SOA condition. We conclude that greater than normal AD priming is a function of controlled processing rather than semantic network degradation.

Functional imaging, the frontal lobes, and dementia.

A 58-year-old man developed progressive difficulty with comprehension and verbal output with dementia. Positron emission tomography with 18F 2-fluoro-2-deoxy-D-glucose demonstrated asymmetrical frontal and anterior temporal lobe loss of glucose use. Scopolamine infusion (0.3 mg) did not influence memory. Postmortem studies revealed evidence of Pick's disease, with Pick bodies, loss of somatostatin, preservation of choline acetyltransferase and immunostaining with neurofilament antibodies. Pharmacological challenge and positron imaging offer valuable means for the noninvasive assessment of dementing illness. The contributions of functional imaging to our knowledge of frontal involvement in dementing illness are reviewed.

Semantic priming of word pronunciation and lexical decision in schizophrenia.

Experimental assessments of semantic memory structure and function in schizophrenic subjects can be a useful approach for delineating some of the information processing deficits in schizophrenia. In this study, a pronunciation and a lexical decision semantic priming experiment were conducted with 19 schizophrenic subjects and 20 normal controls. A short stimulus-onset asynchrony (250 msec) and a relatively low proportion of related prime-target pairs were used in order to examine automatic priming and in order to avoid the contribution of attentional, controlled processes. On the pronunciation task, schizophrenic subjects showed a significant priming effect, equal to the priming shown by normal controls. However, on the lexical decision task, schizophrenics, unlike normal controls, did not show a priming effect which is significantly greater than zero, even though the group difference in priming effect (interaction of priming effect by group) was nonsignificant. The lack of priming on the lexical decision task is consistent with the hypothesis that schizophrenic subjects may show abnormalities in the realm of post-lexical, controlled information processing. The equal-to-normal priming for schizophrenic subjects indicates that the basic structure of the semantic network, including associations among related concepts, is intact in schizophrenia, and that spreading activation also occurs normally.

Automatic semantic priming with various category relations in Alzheimer's disease and normal aging.

The 6 experiments reported here tested the effects of various category relations on automatic semantic priming in 20 Alzheimer's disease (AD), 20 older control, and 22 younger control subjects. The tasks were either word pronunciation or lexical decision; the prime-target stimulus-onset asynchrony (SOA) was always 250 ms. A variety of category relationships between prime and target were examined: highly associated category comembers, subordinate-superordinate or superordinate-subordinate pairs, and pairs selected on the basis of category typically to form typical-typical, atypical-typical, typical-atypical, and atypical-atypical pairings. Both for AD versus older control subjects and for older versus younger control subjects, no significant group differences were found in the magnitude of overall semantic priming or in the effects on priming of factors pertaining to the prime-target relationship.

Visuoconstructive performance and regional cerebral glucose metabolism in Alzheimer's disease.

The drawings of Alzheimer's disease (AD) patients and elderly control subjects were rated on a number of specific performance scales, such as attention to configuration, attention to detail, and stimulus boundedness. AD patients showed significantly poorer performance than controls on most drawing scales, and the drawing measures were differentially affected by disease severity. Regional cerebral glucose metabolism (rCMRglc) was assessed via positron emission tomography (PET, with 18FDG) in a subgroup of the AD patients. Partial correlations of rCMRglc with drawing measures (age, sex, and education served as control variables) were conducted. Five out of eight of the drawing measures were significantly correlated (p less than .005) with rCMRglc in occipital and/or temporal-parietal regions, for both left and right hemispheres. Only one of the eight drawing measures, attention to detail, was significantly correlated with rCMRglc in both frontal and posterior regions of interest, again for both hemispheres. Overall dementia severity showed no significant correlations with rCMRglc in any of the regions. These findings are suggestive of a posterior-anterior differentiation, but no left-right hemisphere differentiation, in the relationship between drawing performance and cerebral metabolism in AD, which cannot be accounted for by overall dementia severity. Differences between the drawing performance of AD and unilateral brain damaged patients are discussed, and further applications of the rating scales (provided in the Appendix) are suggested.

Regional cerebral glucose transport and utilization in Alzheimer's disease.

We performed dynamic positron emission tomographic (PET) studies of glucose utilization, using (18F) 2-fluoro-2-deoxy-D-glucose (FDG), in patients with probable Alzheimer's disease (AD) and healthy age-matched controls, to evaluate blood-brain-barrier glucose transport and glucose utilization rates in the disease. We found no significant differences in rate constants for glucose transport (k1 and k2) and phosphorylation (k3), nor for the vascular fraction (fv), between the 2 groups, although k3 and fv were relatively depressed in temporal cortex in AD. Absolute rates of glucose use were depressed in temporal and parietal cortex, and relative rCMRglc rates were lower in frontal, temporal, parietal, and occipital cortices. These data suggest that in AD bidirectional glucose transport is intact, and that temporal-parietal hypometabolism is present upon a background of widespread cortical metabolic impairment.

Memory and regional cerebral blood flow in mildly symptomatic Alzheimer's disease.

We performed SPECT perfusion imaging and memory testing with mildly and moderately demented Alzheimer's disease (AD) patients and with healthy controls. All patients had memory abnormalities, but 5 of the 21 patients had neither temporal nor parietal perfusion abnormalities, indicating that temporoparietal blood flow may be normal at a point when memory is pathologic and the clinical diagnosis of AD is possible.

Lexical decision and priming in Alzheimer's disease.

Patients with probable Alzheimer's disease (AD) were no faster at making lexical decisions to targets preceded by a semantic prime than to those preceded by an unrelated prime, in contrast to the facilitatory effect of semantic primes for controls. Fewer errors were made by both subject groups on the targets that followed related items, indicating the preservation of associative relationships in AD. The AD patients and controls showed similar effects on lexical decision of repetition priming, word frequency, and the degree to which nonwords approximated real words. The abnormal priming effect in AD may stem from increased susceptibility to lateral inhibition in the semantic network.

Memory in chronic alcoholics: effects of inconsistent versus consistent information.

Alcoholics and controls were compared on their resistance to misleading information given after a witnessed event. The eyewitness testimony paradigm of Loftus, Miller, and Burns ("Semantic Integration of Verbal Information in a Visual Memory" Journal of Experimental Psychology: Human Learning and Memory, Vol. 4, pp. 19-31, 1978) was used, which is a naturalistic variation of a retroactive interference paradigm. Alcoholics did not show greater suggestibility than the controls, being no more "fooled" by the misleading, after-the-fact information. In contrast, alcoholics did show significant impairment in discriminating correct from among incorrect verbal statements about the accident. Thus, certain aspects of memory functioning may be preserved even while others are compromised as a result of chronic alcohol abuse.

Retrieval from semantic memory in Alzheimer-type dementia.

Retrieval from semantic memory, measured by tasks requiring subjects to name items from a given category, was studied in mild Alzheimer-type dementia (Mild-ATD) subjects, moderate-to-severe Alzheimer-type dementia (MS-ATD) subjects, and normal controls. Semantic retrieval performance was shown to be highly sensitive to both the presence and the severity of ATD. Retrieval from both semantic categories and letter categories showed differences in the rate of production of correct responses between subject groups. These rate differences were not due to differences in accessibility of low-dominance semantic category members or low-frequency letter category members. An increase in errors as well as a decrease in correct responses contributed to the performance deficits of the ATD subjects. Furthermore, the pattern of errors changed from Mild- to MS-ATD. Qualitative as well as quantitative differences were also observed in the performance of Mild- versus MS-ATD groups on a third type of semantic retrieval task--the supermarket task. As performance of the ATD subjects declined on these semantic retrieval tasks, so did their performance on other tasks assessing primarily attention, language, and memory. The findings are discussed in terms of the progressive breakdown in both attentional and semantic memory functions which are associated with ATD.

Differences in lateral hemispheric asymmetries of glucose utilization between early- and late-onset Alzheimer-type dementia.

Positron emission tomography with [18F]fluorodeoxyglucose revealed greater right than left hemispheric impairment of cortical glucose metabolism in patients with probable Alzheimer's disease who were younger than 65 but not in those over 65. This asymmetry was related to poor visuospatial performance.